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Virtual rehab improves physical reality

Fall 2012

Ashok Kuchinad is 72 years old. When he started having trouble with his speech he believed it was just part of getting older. In 2004 Kuchinad met Dr. Mandar Jog at a party. That’s when he learned it was much more.

As the Director of the National Parkinson Foundation Centre of Excellence at London Health Sciences Centre and a scientist at Lawson Health Research Institute, Dr. Jog believed Kuchinad was struggling with symptoms of a neurological disorder. A few weeks later a quick round of tests confirmed the diagnosis: Kuchinad had Parkinson’s disease.

Medication and physiotherapy helped. Kuchinad remained active and could still walk briskly around the block. As a retired engineer, he always prided himself on being the handyman around the house; but suddenly small tasks were becoming difficult.

“It was hard to get out of the car,” Kuchinad says. “I would go to open the door and it would swing out and then swing right back. Out and in and out and in – I couldn’t catch it.”

According to Dr. Jog, patients with Parkinson’s disease often struggle with these types of tasks. “Most of us don’t do our daily activities in a controlled style, like walking up and down a long corridor in a straight line,” he says. “To successfully navigate in our environments, gait, vestibular, ocular, and motor systems all have to be combined.”

Patients with Parkinson’s disease struggle with this type of multitasking. The volume of decisions can be overwhelming, putting them at high risk for falls and reduced mobility. Kuchinad has had two falls this year alone.

Patients like Kuchinad need a form of rehabilitation to help them manage everyday activities.

To fill this gap, Dr. Jog and his team launched a new research project using augmented immersion virtual reality (AIVR). AIVR allows patients to perform real-life activities within a simulated environment.

In the pilot project, patients complete three scenarios: watering plants in their home, crossing the street at a cross-walk and choosing items from a grocery store shelf.

Each scenario has been created virtually on a computerized system and is transmitted to patients through a set of virtual reality goggles. As patients move around, a series of sensors and markers indicate where the walls, windows and other objects are located. Real objects, like cereal boxes, are also placed within the environment for the patients to interact with.

“The advantage of virtual reality is that if you were to take a patient across the street to train them, it could present a risk to their safety,” Dr. Jog explains. “In our facility, we can simulate the cars, but in a controlled environment where patients can engage in rehabilitation without being in any real danger.”

Each patient completes the exercises once a week for three weeks. As they move through the scenarios, Dr. Jog and his team track their balance, gait and other data. Through technology, Dr. Jog hopes to shed new light on mobility challenges facing patients with Parkinson’s disease.

“We are now entering a new and innovative world of augmented virtual reality to help aid in improving how rehabilitation is provided to patients with degenerative neurological disorders,” he says.

Kuchinad, who participated in the project this summer, feels optimistic. He looks forward to the day he can be the handyman once more.

“Keeping busy is the secret to keeping your sanity,” he says. “This rehab program would be good. There isn’t any kind of physiotherapy like this for patients with Parkinson’s disease. I wish Dr. Jog and his team success and good luck.”

More than fun and games

Virtual reality technologies are most commonly seen in video games. So when Dr. Jog needed to build his environment, he turned to Dr. Mike Katchabaw, undergraduate chair in the Department of Computer Science at Western University and an expert in gaming entertainment. “It was a great opportunity to collaborate and bring together our two worlds, learn a bit from each other and create something that’s really special,” says Dr. Katchabaw.

Community Support

In addition to his important research, Dr. Mandar Jog is Director of LHSC’s movement disorders program – a unique, integrated neurology/neurosurgery research and treatment facility that cares for patients with Parkinson’s disease, Huntington’s disease, dystonia, tremors and Tourette syndrome. The program is having such a strong impact that one of its patients, Joseph Szecsei, along with his wife Magdalena, recently donated $100,000 towards the program and its research in Parkinson’s disease. “We are grateful for the care and happy to be able to support such an important initiative,” say the Szecseis.

Want to learn more about this research?

Dr. Mandar Jog, neurologist and director of the National Parkinson Foundation Centre of Excellence at London Health Sciences Centre and scientist at Lawson Health Research Institute, explains how his virtual reality research is delivering physical benefits to patients with Parkinson's disease.